What is ImPACT?
The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is a computerized neurocognitive test battery used to assess a variety of cognitive skills related to symptoms associated with mild traumatic brain injury and concussion.
A concussion is primarily a pathophysiological event and therefore needs to be assessed using specialized instruments which examine cognitive and clinical symptoms rather than structural problems. This evaluation is used to differentiate between normal cognitive performance and cognitive performance following a mild traumatic brain injury/concussion or suspected concussion.
ImPACT is an evaluation tool designed to measure neurocognitive abilities at three different stages: baseline, prior to any head injury, and then again after an injury or suspected injury has occurred. When combined with other assessments, this test can provide an accurate measure of the severity and characteristics of the head injury. The ImPACT test design permits multiple post-injury measures at different intervals during recovery to allow for documentation of progression through the injury.
This documentation is vital in terms of the overall management of a concussion, as it is used to make determinations about returning to daily routines including physical activities, academics, and return to playing a sport.
Who should take ImPACT?
ImPACT baseline testing and post-injury testing is designed primarily for athletes between the ages of 12 and 59 years 11 months of age who are either currently involved, or have been involved, in contact sports.
The purpose of baseline testing is to provide a valid measure, which is then used to compare an individual’s behavior and cognitive skills while healthy, to their behavior and cognitive skills when they are or may be injured. Baseline testing is important in terms of determining the severity of an injury and the length of time it may take to recover from that injury.
The ImPACT test takes approximately 20-25 minutes to complete which is considered a relatively short amount of time for a comprehensive neurocognitive assessment. It can be administered to individuals ages 12 years to 59 years 11 months in an individual setting (ie. 1 test taker), or in group settings with up to 20 individuals taking the test at the same time.
The test includes the following components:
- Demographic information -information about yourself such as your age
- Symptom Scale – provides information about the different symptoms associated with concussion (ie. Nausea, sleeping, headaches)
- Word Memory task
- Design Memory task
- X’s and O’s task
- Symbol Match task
- Color Match task
- Three Letters task
- Detailed Clinical Report
ImPACT provides scoring within the software which is available immediately following completion of the test. In addition to scores for each task/module, ImPACT also provides composite scores, a symptoms score, a reliable change index, and information about reactions times and impulse control. Through the use of a normative database, these scores provide important information about where an individual’s performance ranks relative to their peers, as well as providing data about how an individual is performing relative to themselves.
The same testing framework is used for Post-injury testing. The same test battery that was used for baseline testing is used. All the elements of the baseline test are essentially repeated in the same order so that they can be compared with baseline test results.
When should you give the first post-injury test?
The post-injury assessment can be performed within 24-72 hours post-injury identification unless a severe head injury or skull fracture is suspected. Even if symptoms of a concussion are present, the assessment may be administered. It is recommended that no more than two ImPACT tests are performed within a seven day period. Other than this criteria, this test may be administered at various intervals throughout the recovery process.